Clinico-epidemiological, histopathological, and cytogenetic profiling of non-Hodgkin lymphoma at a tertiary care hospital in Maharashtra, India: A 4-year combined prospective and retrospective observational study

ABSTRACT Background: Despite the growing burden of non-Hodgkin lymphoma (NHL) in India, comprehensive data integrating epidemiological, histopathological, and molecular profiles remain limited in many tertiary care settings. To characterize the clinico-epidemiological features, histopathological subtypes, immunophenotypic profiles, and cytogenetic abnormalities and to evaluate the associations between selected markers and disease stage among patients diagnosed with NHL at a tertiary care hospital in Maharashtra, India. Materials and Methods: This combined prospective and retrospective observational study, reported in accordance with STROBE guidelines, enrolled 64 consecutive patients with histopathologically confirmed NHL between January 2021 and December 2024. Histopathological classification, immunohistochemical (IHC) profiling, and fluorescence in situ hybridization (FISH) targeting MYC, B cell lymphoma 2 (BCL2), B cell lymphoma 6, and immunoglobulin heavy locus rearrangements were performed. Results: The mean age was 52.2 ± 16.3 years (male-to-female ratio 1.9:1). Diffuse large B-cell lymphoma (DLBCL) was the predominant subtype (59.4%), with 50.0% classified as germinal center B-cell-like (GCB) and 42.1% as non-GCB by the Hans algorithm. The majority (64.1%) presented at advanced stages (III–IV). BCL2 rearrangement (21.9%) was the most common cytogenetic abnormality. Double-hit lymphoma was identified in 3.1%. BCL2 protein expression (IHC; P = 0.01) and MYC protein expression (IHC; P = 0.02) were associated with advanced-stage disease. BCL2 rearrangement (FISH) was associated with bone marrow involvement ( P = 0.02). These findings should be interpreted cautiously, given the small sample size and exploratory nature of the analyses. Conclusion: DLBCL was the predominant subtype, frequently presenting at advanced stages, with the GCB subtype being predominant. Cytogenetic profiling, particularly for BCL2 and MYC rearrangements, provides additional characterization, which may aid in risk stratification and warrants validation in larger cohorts with survival data.